When male factor infertility is suspected, the initial test performed is a semen analysis. A semen analysis allows the doctor to examine the count, motility and morphology of the sperm. At Georgia Reproductive Specialists, we prefer a formal semen analysis over the post-coital test and consider the semen analysis to be more useful in the fertility evaluation.
Sperm count - The normal range for sperm is between 40 and 300 million sperm per milliliter of ejaculate. A low sperm count is fewer than 20 million per milliliter of ejaculate.
Motility - Low sperm motility (movement) may reduce the chances of conception, especially when paired with low sperm count. In a normal semen sample, at least half of the sperm have typical movement.
Morphology - Sperm that do not have normal morphology (shape) are often unable to swim effectively or penetrate an egg. A normal sperm has an oval head, slender midsection and tail that moves in a wave-like motion.
In order for a physician to evaluate the count, motility and morphology of sperm, a semen sample must be provided. The sample is most often collected by masturbation in a private, comfortable room in the fertility center. In some cases, the sample may be collected at home by masturbation or during intercourse with the use of a special condom provided by the physician. In some cases, the test results are not normal due to problems during sample collection and the test must be repeated.
Depending on the results of the semen analysis, more tests can be ordered to diagnose specific causes of infertility. If the semen analysis shows clumping or signs of infection, a semen culture, prostate fluid culture and urinalysis may be ordered. An antisperm antibody test may also be ordered to evaluate potential immune system disorders. A fructose test can be used to evaluate structural problem or a blockage of the seminal vesicles.
Sperm Chromatin Structural Assay (SCSA) - New studies suggest that sperm with certain levels of DNA fragmentation serve as a strong predictor of reduced male fertility. Georgia Reproductive Specialists is now offering SCSA, a test to measure the level of DNA fragmentation in the sperm, to enhance the diagnosis of and treatment for male infertility. A review of data on hundreds of semen samples show that patients with a DNA fragmentation level of greater than 30% are likely to have significantly-reduced fertility potential as well as a greater risk of miscarriage.
